外科感染常见病原菌构成及耐药情况分析

目的 了解外科感染常见病原菌构成及耐药情况,为临床合理使用抗生素提供依据.方法 回顾性分析2008年1月至2010年12月外科送检标本的病原菌组成及耐药性.结果 共分离出病原菌321株,其中革兰阴性杆菌201株,占62.6％;革兰阳性球菌114株,占35.5％;真菌6株,占1.9％.其中大肠埃希菌116株(36.1％)、肺炎克雷伯杆菌24株(7.5％)、金黄色葡萄球菌34株(l0.6％)、铜绿假单胞菌18株(5.6％)、粪肠球菌16株(5.0％).葡萄球菌中金黄色葡萄球菌耐甲氧西林葡萄球菌(MRS)、凝固酶阴性葡萄球菌MRS和超广谱β内酰胺酶(ESBLs)的检出率分别为52.9％(18/34)、83.7％(36/43)和35.0％(49/140).常见革兰阴性杆菌对哌拉西林/他唑巴坦、头孢他啶、阿米卡星、亚胺培南和美洛培南的耐药率均低于20％.常见革兰阳性球菌中,葡萄球菌对复方磺胺甲噁唑、米诺环素、利福平、万古霉素、替考拉宁和夫西地酸等的耐药率均低于40％,各种病原菌的耐药性各不相同.结论 外科感染标本的病原菌分布广泛,细菌耐药性各异,一些感染菌株多重耐药,引起临床经验性治疗失败,临床应根据实验室药敏结果合理使用抗生素,避免抗生素的滥用.

Analysis on composition and antibiotic resistance of pathogenic bacteria in surgical infection

Objective To study the etiology of surgical infection and antibiotic resistance of infective bacteria,so as to provide evidence for clinical treatment.Method The composition and antibiotic resistance in surgical specimens of pathogenic bacteria from January 2008 to December 2010 was analyzed retrospectively.Results A total of 321 pathogens isolated,Gram-negative bacteria 201,accounting for 62.6％,Gram-positive cocci 114,accounting for 35.5％,Fungus 6,accounting for 1.9％.Escherichia coli 116(36.1％),Klebsiella pneumoniae 24(7.5％),Staphylococcus aureus 34(10.6％),Pseudomonas aeruginosa 18(5.6％),Enterococcus faecalis 16(5.0％).Staphylococcus species of Staphylococci methicillinresistant Staphylococcus atureus(MRS),Coagulase-negative staphylococci MRS and ultra wide-spectrum beta-lactamases(ESBLs)detection rate was 52.9％(18/34),83.7％(36/43)and 35.0％(49/140),respectively.The resistance rates of Gram-negative bacilli to piperacillin/tazobactam,ceftazidime,amikacin,imipenem and meropenem were below 20％,Gram-positive cocci,staphylococci to new compound sulfamethoxazole,minocycline,rifampin,vancomycin,teicoplanin and fusidic acid resistance rates were less than 40％,various pathogens had varies resistance.Conclusions Specimens of surgical infection pathogens widely distribute in different drug-resistant bacteria,some strains of multi-drug resistant infection,causing clinical failure of empirical therapy,clinical laboratory susceptibility results should be based on the rational use of antibiotics,to avoid the overuse of antibiotics.